HomeMy WebLinkAboutPermit Electrical 1997-4-29
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225 FIFTH STREET . I TV}
SPRINGFIELD, OREGON 97477 Zoning LA./I!.-
INSPECTION REQUEST: 726..!3'76~ - 2 Cj '77
OFFICE: 726-3759 . . I
Aut:-'onzed Signature IV M
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1. LOCATION-9f INSTALLATION
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LEGAL DESCRIPTION
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Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor ~/~~~
Address
City
Phone
Supervisor License Number
Expiration Date
ELECTRICAL PERMIT APPLICATION
City Job Number -:t70"'?4?
OOUDTVT~EE SCHEDULE BELOY
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cos t
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home. or
Modular .Dwelling
Service or Feeder $ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervising Electrician
D.
Owners Name . 2?~}? ./f:i;??hl,~
Address, 7L 9~ ~~/~~~
Ci ty A~.b>~Phone 72~ -72 ::;:-,
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OYNER INSTALLATION
The installation is being made on
property I own which is not intended
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RECEIPT D: ~ ~ -?~
RECEIVED BY: /' /-'d-!'-
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B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to. 1000 amps
Over 1000 amps/volts
Reconnect Only
200 amps' 'or less $ 40.00
201 amps to 400 amps $ 55.00
Over 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see "B" above
Branch Circuits
New, Alteration or Extension Per Panel
"
One Circuit -----s 35.00 ::? 5:-:;>
Each Additional
Circuit or with Service
or Feeder Permit $ 2.00
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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